Kennesaw State University

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

KENNESAW STATE UNIVERSITY

Practice address

5050 Spring Valley Rd
Dallas, TX 75244-3995

Phone

(972) 367-4845

Fax

(972) 367-3451

NPI assigned

Mar 4, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erin Wolfe

Title

Procurement Manager

Phone

(770) 420-4355

Specialties & licenses 1

Addresses

Other names 1

• Kennesaw State University Counseling Doing business as

Tax ID family

Kennesaw State University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kennesaw State University

  • Student Health Clinic/Center
  • Kennesaw, GA
  • NPI 1518207612
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1134460967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHASTAIN RD NW",
            "address_2": "MD5300 HOUSE 53",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445588",
            "telephone_number": "678-797-2018",
            "fax_number": "678-797-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995",
            "telephone_number": "972-367-4845",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESAW STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PROCUREMENT MANAGER",
        "authorized_official_telephone_number": "770-420-4355"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennesaw State University Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shacoda Kennedy
• Zachary A Kennedy, MD
• Anna Jeannette Kennell, PT, DPT
• Linda Lee Kenner, P.T.
• Donald A Kennerly, MD
• Kenneth C. Killen M.D. PA
• Kenneth C. Killen, MD, PA
• Kenneth I Uzick OD PC
• Kenneth R Dority DO PA
• Kenneth R Kollmeyer MD PA

• Counseling Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.